Brustzentren

Brucker, Sara Y.; Krainick, U.; Bamberg, M.; Aydeniz, B.; Wagner, Uwe; Bois, Andreas du; Claussen, CD; Wallwiener, D.

doi:10.1007/s00129-003-1426-2

Cited by 22 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Primary BC treatment followed the S1-guidelines [6–9]. Cohort 2003–04 was exposed to an “integrated care” model defined by a certified BC center [13]. Primary BC treatment followed recommendations of the national S3-guidelines [10].…”

Section: Methodsmentioning

confidence: 99%

“…The application of these S3-guidelines was mandatory for centralized BC networks inspired by so called “hub & spoke” models [13–15]. Hubs were defined by academic institutions, and spokes refer to all of the related health care professionals.…”

Section: Introductionmentioning

confidence: 99%

“…Hubs were defined by academic institutions, and spokes refer to all of the related health care professionals. A network-wide monitoring of guideline application was assured by quality management systems, which became officially certified [13]. Multidisciplinary counseling was assured by expert panels (tumor conferences) hosted at comprehensive cancer centers.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The adherence paradox: guideline deviations contribute to the increased 5-year survival of breast cancer patients

2015

View full text Add to dashboard Cite

BackgroundIn German breast cancer care, the S1-guidelines of the 1990s were substituted by national S3-guidelines in 2003. The application of guidelines became mandatory for certified breast cancer centers. The aim of the study was to assess guideline adherence according to time intervals and its impact on survival.MethodsWomen with primary breast cancer treated in three rural hospitals of one German geographical district were included. A cohort study design encompassed women from 1996–97 (N = 389) and from 2003–04 (N = 488). Quality indicators were defined along inpatient therapy sequences for each time interval and distinguished as guideline-adherent and guideline-divergent medical decisions. Based on all of the quality indicators, a binary overall adherence index was defined and served as a group indicator in multivariate Cox-regression models. A corrected group analysis estimated adjusted 5-year survival curves.ResultsFrom a total of 877 patients, 743 (85 %) and 504 (58 %) were included to assess 104 developed quality indicators and the resuming binary overall adherence index. The latter significantly increased from 13–15 % (1996–97) up to 33–35 % (2003–04). Within each time interval, no significant survival differences of guideline-adherent and -divergent treated patients were detected. Across time intervals and within the group of guideline-adherent treated patients only, survival increased but did not significantly differ between time intervals. Across time intervals and within the group of guideline-divergent treated patients only, survival increased and significantly differed between time intervals.ConclusionsInfrastructural efforts contributed to the increase of process quality of the examined certified breast cancer center. Paradoxically, a systematic impact on 5-year survival has been observed for patients treated divergently from the guideline recommendations. This is an indicator for the appropriate application of guidelines. A maximization of guideline-based decisions instead of the ubiquitous demand of guideline adherence maximization is advocated.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1765-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The adherence paradox: guideline deviations contribute to the increased 5-year survival of breast cancer patients

2015

View full text Add to dashboard Cite

show abstract

“…In this context, the quest for strategies to reduce breast cancer morbidity and mortality has focused on the setting required for the optimal treatment of breast cancer because epidemiological and clinical data have pointed to the urgent need for the reorganisation and improved delivery of breast cancer care [4,5]. …”

Section: Introductionmentioning

confidence: 99%

Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care

et al. 2009

View full text Add to dashboard Cite

BackgroundThe main study objectives were: to develop a set of requirements of comprehensive breast centres; to establish a nationwide voluntary certification programme for breast centres based on such requirements, a certified quality management system (QMS), and scheduled independent, external audits and periodic recertification; and to demonstrate the general acceptance of such a certification programme with a view to introducing similar certification programmes for other major cancers.MethodsBreast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data (numbers of pending and successful applications, sites/centre, etc.) were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.ResultsRequirements of Breast Centres were developed by the German Cancer Society (DKG), the German Society of Senology (DGS) and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists' (EUSOMA) requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.ConclusionNationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.

show abstract

“…Es ist anzunehmen, dass jede 7. deutsche Frau im Laufe ihres Lebens an Brustkrebs erkranken wird [4]. Diese Zahlen perkutanen Biopsieverfahren ist dann nötig [22].…”

Section: Allgemeinesunclassified

Komplikationsrate, Patientenzufriedenheit und therapeutische Möglichkeiten der Vakuumsaugbiopsie

Heim¹,

Lux²,

Heim³

et al. 2013

Senologie - Zeitschrift für Mammadiagnostik und -therapie

View full text Add to dashboard Cite

Brustzentren

Cited by 22 publications

References 21 publications

The adherence paradox: guideline deviations contribute to the increased 5-year survival of breast cancer patients

The adherence paradox: guideline deviations contribute to the increased 5-year survival of breast cancer patients

Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care

Komplikationsrate, Patientenzufriedenheit und therapeutische Möglichkeiten der Vakuumsaugbiopsie

Contact Info

Product

Resources

About